In a world which is increasingly being driven by science and technology, traditional medical systems like Ayurveda are under pressure to stand up to the rigors of modern scientific testing. As we know in nature-based systems multiple factors interact with each other simultaneously, to give rise to complex outcomes. Therefore, it needs to be considered whether these systems can be interpreted in terms of modern scientific method or whether they are beyond such interpretation. Further, it also needs to be pondered as to whether it is possible to undertake research in Ayurveda based on modern scientific principles, if not, what kind of research is possible, writes S Jaleja IAS, former Secretary at Department of Ayush, Government of India.
Since the 17th century natural science has been characterized by modern scientific method which consists of a series of steps involving systematic observation, measurement, experimentation as well as formulation, testing, and modification of hypotheses. Modern science, with the aid of this approach, has been able to interpret the world around us to a great extent and provide us with an unprecedented standard of health and well-being, extending average human life expectancy to 71 years. However, the limits of modern science has been greatly felt now as never before, especially in the treatment of diseases. A wide range of chronic diseases can only be regulated not cured completely; newer and deadlier diseases keep appearing for which modern medicine has very little to offer.
Traditional systems appear to be beyond objective analysis. They conform to subjective analysis wherein all senses appear to act together providing meaningful insights to the observer. Synergistic effect of interactions amongst constituents of nature- based medicines is not well understood. While the ‘observer’ and the ‘observed’ are separate in modern scientific method, there is no such distinction in traditional systems. By seeking evidence-based Ayurveda the accepted principles of one system are being forcibly imposed on another system from which it fundamentally differs. Thus in interpreting traditional systems like Ayurveda perhaps one has to extend the frontiers of modern science beyond what is accepted now. In this realization lies the basic approach to research in Ayurveda.
Late Raghavan Tirumulpad, the legend of Ayurveda when once asked about research in Ayurveda cryptically replied “Research is re-search”. What he perhaps meant was that Ayurveda is a complete medical system and through research what already exists in it can only be rediscovered. The knowledge we have inherited is time- tested which involves compilation of knowledge from various sources, keen observation of the patients, in-depth study of the diseases, standardization of treatment unique to each patient, carefully drawing inferences and recording the practices. Ordinarily, after these steps further confirmation of the practices followed is not needed. However, people influenced by the ethos of modern medicine are skeptical about “untested’ systems and of the practices prescribed in them . To make the system widely acceptable to all categories of people and for the benefit of humanity as a whole research or re-testing the efficacy of treatments prescribed in Ayurveda seems to be necessary.
What we know today Ayurveda is only a part of a vast knowledge system. It is in fact a gold mine of medical knowledge. Research into classical texts of Ayurveda can throw light on more of plant based medicines and modes of treatments for many more diseases. It may be remembered that Ayurveda is not based on a unitary source; it is a compilation of knowledge which flowed from different regions and cultures in India, both near and far. In fact Charaka Samhita itself is a codification of knowledge from multiple sources available at that point of time. Surprisingly the different systems which contributed to Ayurveda shared a similar world view. Herein lies the core strength of Ayurveda which enabled it to survive the onslaught by modern medicine for over a century.
Late Tirumulpad also had pointed out in the context of research in Ayurveda that the most important aspect of treatment is ‘pathya‘ (diet and exercise). All research in Ayurveda today, on the contrary, is directed to developing medicines akin to those in modern medicine, with instant curative properties. Research , therefore, needs to be undertaken involving the whole treatment system, including the mental state of the patient. It follows that any clinical trial involving efficacy of nature-based medicines / plant extracts ought to be taken up along with other factors, including pathya. Although protocols have been developed by the AYUSH Department, clinical trials based on those are yet to be undertaken in a big way.
Integrated medicine is becoming more popular today, especially with regard to chronic diseases. Again it needs to be stressed that research into efficacy of integrated medicine ought to retain salient features of Ayurveda, including classification of body types, treatment tailored to suit the body constitution, as well as pathya.
The unique contribution of Ayurvda lies in its conceptualization of health-cosmic forces influencing bodily functions maintaining a state of equilibrium, disease being vitiation of that balance, and the categorization of human beings into three body types and the treatment offered based on this concept. This world view has enabled Ayurveda to fit any new disease into that frame work and treat the disease wherein western medicine has so far failed to come up with solutions. This conceptualization of health has withstood the test of time. This itself can offer an interesting area for research.
To sum up
- We need to undertake research in Ayurveda retaining the unique nature of the system
- Those who undertake research ought to have a clear understanding of holistic nature of research in Ayurveda
- Freedom, flexibility and funding are pre-requisites of quality research. AYUSH Ministry ought to provide an enabling environment to carry out research.
- Our research institutions ought to be designed in such a way to carry out high end research into efficacy of treatment protocols rather than of single medicines or medicines in combination.
- Periodic training in research methodology/ research publication ought to be undertaken in partnership with reputed organizations.
- Research into classical texts of Ayurveda ought to be encouraged; suitable incentives ought to be provided to those interested.
- Research ought not be limited to Research Councils and government organizations. Research by private organizations/Trusts also ought to be encouraged. Large allocation of funds would be necessary to encourage quality research.
- Industrial establishments too may be provided necessary support to undertake research in Ayurveda.
- Partnership with reputed universities/organizations outside too could be taken up to enhance the quality of research.
- Inter-sectoral research ought to be encouraged.
Now that the Central Government has set up a separate Ministry of AYUSH, we can hope that research in Ayurveda and other traditional systems of medicine will receive a big boost.
S Jaleja IAS
Former Secretary at Department of Ayush
Government of India